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"False-Positive" Myocardial Perfusion Scintigraphy Findings in Patients with Angiographically Normal Coronary Arteries: Insights from Intravascular Sonography Studies

Departments of Cardiology and Nuclear Medicine, Ospedale di Circolo and Fondazione Macchi-University Hospital, Varese, Italy

View larger version (13K): [in this window] [in a new window]   FIGURE 1. Mean RPA at site of maximum plaque concentration by intravascular sonography as estimate of plaque burden in target vessels and reference vessels.

View larger version (13K): [in this window] [in a new window]   FIGURE 2. Mean Doppler CFR in target vessels and reference vessels.

View larger version (12K): [in this window] [in a new window]   FIGURE 3. Relationship between summed reversible defect score (SRS) by exercise 99mTc-sestamibi scintigraphy and ratio of CFR of target and reference vessels (coronary reserve ratio [CRR]).

View larger version (87K): [in this window] [in a new window]   FIGURE 4. Findings from exercise myocardial scintigraphy (left middle image), coronary angiography (right middle image), intravascular sonography (top 2 images), and Doppler flow velocity measurement (bottom 2 images) for 56-y-old woman with chest pain on exercise and reversible perfusion defect of anterior left ventricular wall (arrows). Intravascular sonography shows eccentric soft plaque, missed by angiography, involving mid left anterior descending (LAD) artery. This finding is associated with relative reduction of CFR in territory of LAD artery. LA = lumen area; LCX = left circumflex artery.